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oral sex - blood in mouth
May 24, 2002

Dear Doctor,

Met a girl. My friend and me both received oral sex from her (unprotected) and both had protected vaginal sex with her. We both after two weeks got really ill. He was diagnosed with strep throat while I had an inconclusive diagnosis. I had three blood red spots on my arm during the course of my illness which did not itch and was totally flat did not burn and went away in a couple of hours. A cbc result during the time of the illness showed lower platelets then normal and low white blood cells (no anemia, lymphocytes at 40 ) After speaking to this girl we found out that she is HIV positive and frequently bleeds from her mouth.

I have tested negative 9 months after exposure with a pcr dna qaul at 3 months negative after exposure.

1) I have heard having blood in mouth guarantees HIV infection if oral sex is performed on you.

2) I have had classical ars symptoms that went away and still tested negative (How is this possible)

3) I have been feeling very depressed and anxious for the past 9 months and last three months have had chronic dizziness the whole day any chance this is related to stress.

4) As I saw the rash in the day only on arms and HIV rash appears on the trunk (commonly) is it possible that the rashes appeared on my trunk and went away in a couple of hours and I did not notice them on the trunk as they could have occurred in the night

5) I have been diagnosed with chronic pharyngitis and a chronically swollen salivary gland on the right side can this be related to HIV infection ( I am a heavy smoker)

6) My cd4/cd8 ratio stands at 1.8 after 7 months (I know no relevance but helps the mind right) cd4 at 62 and cd8 at 34

Please try and make sense of this and help me out as I do not know what to do. Want to get married but to fearful.

Love

Oral Sex Nightmare

Response from Dr. Frascino

Hello,

Just a reminder to everyone that this forum is dedicated to HIV-related fatigue and anemia. The "am I infected?" questions should be sent to our Safer Sex/HIV Prevention forum. I'll try to reply briefly:

1. You heard "having blood in mouth guarantees HIV infection if oral sex is performed on you?" Exactly whom did you hear that from? A used car salesman, perhaps? No, blood in the mouth does not guarantee HIV infection, although it may increase the risk. 2. You had "classic ARS symptoms" that went away and you tested negative. How is this possible? That's an easy one. The symptoms were caused by something other than HIV. By the way, most "classic ARS symptoms" are indeed caused by something other than HIV! 3. Depressed, anxious, dizzy - could this be related to stress? That's another easy one. Absolutely. In fact, these are "classic stress symptoms". I'd suggest seeing a therapist to help you cope with these feelings. 4. Disappearing rashes are always hard to comment on. However, since your tests are conclusive, you can rest assured it was not HIV-related! 5. Chronic pharyngitis, and a chronic swollen salivary gland in a heavy smoker is related to your smoking not HIV. You should have your doctor check this out. Remember, you tested negative, but you continue to light up those cigarettes. If you are really concerned about your health, you should be focusing on the very real possibility that cigarettes will indeed kill you, not non-existent HIV! I strongly recommend quitting! 6. Your lab tests are normal, so what's the question?

Bottom line:

1. Your HIV tests are negative at 9 months and DNA/PCR negative at 3 months. You are not HIV-infected. 2. Anxiety and stress are responsible for many of your symptoms. See a therapist for help. You'll be glad you did. 3. Smoking is by far the most likely cause of your chronic pharyngitis and swollen gland. Quit. You'll be glad you did. 4. Attending to numbers 2 and 3 above will make your ultimate goal of getting married much easier.

So now you know HIV is not your problem.

Get well. Stay Well. Get married and Good luck. And one more thing -- don't invite that same girl to the bachelor party, OK?

Dr. Bob


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